CERT Review Results
To obtain the results of your Comprehensive Error Rate Testing (CERT) review(s), please contact WPS Government Health Administrators at the following email address: CERTPartB@wpsic.com
We have seen increased denials and rejections based on the ICD-10 codes. Help us to process your claims appropriately. Only submit an ICD-10 code on the paper form once in Item 21 even if it applies to multiple lines of service. Use Item 24E to point at the specific diagnosis code in Item 21. Submission of a paper claim requires the fields to be completed correctly. Submission of ICD-10 codes in item 21 starting in section B or not going in order from A to L will cause a denial or rejection of your claim. More information can be found in the CMS Internet Only-Manual (IOM) Publication 100-04, Chapter 26.
Quality Payment Program
On April 27, 2016, the Department of Health and Human Services issued a Notice of Proposed Rulemaking to implement key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), bipartisan legislation that replaces the flawed Sustainable Growth Rate formula with a new approach to paying clinicians for the value and quality of care they provide. CMS has a dedicated Quality Payment Program web page that includes links to numerous resources, including fact sheets, timelines, information about upcoming and past webinars, and more.
WPS GHA is excited to announce we will soon launch our completely redesigned website! Available in 4th Quarter of 2016, the new site has been crafted to improve efficiency and accuracy, and to share user friendly functionality, such as CMS Secure Net Access Portal (C-SNAP) self-service functionality, content and services delivered to any device and improved content find-ability and discover-ability. Please stay tuned for future updates!
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